Take action, make your voice heard.

When nurses assert their voices and take an active role in political advocacy, they can make a real impact. Because we have the experience, expertise, and skills to prioritize evidence-based practice, we hold a position to influence policy decisions. By engaging in nursing politics, nurses can play a pivotal role in improving overall healthcare delivery.

Every day across the country, nurses meet the demands of patients by delivering high-quality care, addressing social determinants of health, and educating patients and family members in various healthcare settings. Although nearly 5 million nurses work in the United States, not many have crossed over to the Congressional setting. Despite this underrepresentation, those few nurses who’ve been elected to office have contributed significantly to healthcare policies. (See Nurse leaders.)

Nurse leaders

Over the years, many nurses have worked as advocates and served as legislators, including the following:

• Lavinia Dock graduated from Bellevue Hospital School of Nursing in 1886. She lobbied for legislation that would allow nurses to control their own profession.
• Eddie Bernice Johnson became the first registered nurse sworn in as a member of Congress in January 2023.
• Lauren Underwood, the youngest Black woman to serve in Congress, has represented Illinois’ 14th Congressional District since 2019.
• Cori Bush became the first Black woman to serve Missouri’s 1st Congressional District in 2021.
• Jen Kiggans became the first nurse practitioner to serve Virginia’s 2nd Congressional District in 2023.

As of the fall of 2024, 72 nurses were serving in 36 different state legislatures and most were up for reelection. In the 118th U.S. Congress (2023–2025), 33 healthcare professionals serve: 30 physicians and three nurses.

Several opportunities exist for nurses to participate in healthcare politics. For example, introducing politics and health policy early in nursing school can help promote awareness, interest, and civic engagement with national healthcare issues. In the workplace, nurses can play a critical role as social–political activists by raising awareness of public health issues with their organization’s leadership and lobbying for change. As individuals, nurses can register to vote, cast their votes, follow nursing and healthcare issues, become campaign volunteers, donate money, run for elected office, and join professional nursing organizations.

Legislative updates

Hackensack Meridian Health (HMH), an 18-hospital network with locations across New Jersey, practices shared decision-making by holding monthly meetings for nurses representing each hospital. These meetings, known as Nursing Congress, include legislative updates on current issues, with the goal of educating and inspiring the more than 100 nurses who attend. The nurses then share this information within individual hospitals, encouraging communication and engagement with state and federal legislators.

Two nurses active in the New Jersey State Nurses Association initiated the legislative update in an effort to share their interest and passion for legislation with their coworkers. The first updates began with education about the legislative process and how a bill becomes a law in New Jersey. Subsequent legislative updates focused on various state, federal, and professional issues. (See Legislative topics.)

As interest in legislative updates grew, with attendees asking questions, sending emails, and even meeting with their legislators, the discussions moved to providing education about running for office. Only one nurse (Nancy Munoz) currently serves in the New Jersey Assembly.

At one legislative update, a representative from the organization Healing Politics spoke about their mission to inspire, motivate, recruit, and train nurses and midwives to run for elected office. Their Campaign School, a 2.5-day program, covers topics that range from campaign planning to media training and fundraising.

The legislative team actively encourages nurse attendees to engage with legislation that aligns with their passions. They have the opportunity to submit bills for discussion or present them personally. This initiative has led to several nurses stepping forward to present bills; some have played key roles in driving local legislation, and others have offered valuable insights into the origins and motivations behind specific bills. This approach informs nurses and empowers them to take an active role in shaping the policies that impact their profession.

Each year before the primary and general elections, the legislative team reminds nurses to vote and encourages those who haven’t registered to do so. The team provides information about voting by mail or in-person. They also inform nurses about specific senators and assembly members who’ve shown support for critical nursing issues. (See Make your voice heard.)

Feedback

After 5 years of providing legislative updates to the growing network of nurses, the legislative team sought feedback on the impact of these sessions. They wanted to know if attending the updates had prompted nurses to reach out to their legislators and what they had learned. The team also asked participants at Nursing Congress to share what they found most and least valuable about the sessions, and how these updates influenced their practice.

In addition, the legislative team wanted to highlight instances when nurses took an extra step by presenting bills, offering insights into legislation, or even driving legislative efforts themselves. These actions would demonstrate a deeper commitment to shaping healthcare policy and advancing the profession.

Among the approximately 100 respondents, 75% attended five or more legislative update sessions. When asked if they had contacted their legislators, 43% said they had, while 48% had not. Of those who reached out, 54% reported receiving a response from their legislators.

Nurses reported gaining valuable insights into how to effectively engage with the legislative process and advocate for issues impacting their profession. Many participants noted increased confidence in reaching out to local legislators and recognized the importance of using their voices to influence key topics, such as violence against healthcare workers and updates to nursing practice regulations. They also learned the significance of knowing their district representatives and actively participating in legislative discussions that directly affect their roles, especially for APRNs.

Nurses said that they appreciated learning about specific pending changes, such as the removal of last names from badge IDs to protect nurse privacy. Overall, nurses reported feeling empowered by the knowledge that decisions made in the voting booth influence their professional practice, reinforcing the importance of staying informed and engaged in legislative matters.

Many respondents noted that the updates showed them how to use their voices to highlight matters that might otherwise go unnoticed. They praised the sessions for being concise, informative, and directly relevant to their profession. Respondents said that the sessions offer a clear way to stay current and influence representatives on healthcare and nursing-related matters. Overall, participants see the updates as a crucial resource for staying engaged with ongoing legislative changes, while also providing a sense of involvement and action.

Some survey respondents suggested areas for improvement, including how to respond when legislative items don’t move forward or when specific bills lack follow-up. Some suggested providing a bulleted list of key points after the updates. The legislative team plans to incorporate these ideas into future updates.

Magnet® and advocacy

The American Nurses Credentialing Center’s Magnet® Recognition Program requires nursing advocacy in the areas of technology, education, policies, resources, and process development. Nurses can advocate for improvements in the workplace (unit policies, practices, and outcomes) through their shared governance structure. These shared decision-making councils help to promote nurse empowerment, and they encourage nurses to participate in issues that impact their daily work environments, patients, and the community.

Nurses who work in organizations that have received Magnet recognition take part in decision-making structures that establish standards of practice and address opportunities for improvement at both the unit and organizational levels. A recent addition to the Magnet manual requests an example of nurse advocacy for individual or community health promotion at an external forum where decisions impacting healthcare are made.

Within HMH’s 18-hospital network, eight have received Magnet recognition. The chief nurse executive, Regina Foley, PhD, MBA, RN, supports the legislative updates throughout the network. She described effective legislative advocacy as strengthening the nursing profession and empowering nurses to influence and shape policies that benefit patients and the healthcare system. She added that the monthly legislative updates provided at Nursing Congress help nurses stay informed and acquire skills to engage in meaningful advocacy, which advances the profession and promotes a healthcare environment that prioritizes patient safety and quality care.

Nursing organizations take action

Many professional nursing organizations actively advocate at local and national levels and include legislative components on their websites. For example, the American Nurses Association advocacy hub, RNAction, works to ensure that association members remain informed and motivated to act on issues that impact nursing. The RNAction toolkit guides nurses on how to connect with members of Congress and includes links to templated emails about the latest bills where nurses can add their names. These opportunities make it easy to remain informed and active. (See Resources.)

Get involved

Organizations can help keep nurses informed and involved in legislation that impacts their work, their work environment, and their patients. They can devote time to legislative updates in professional nursing governance meetings and provide nurses with the resources and support necessary to make their voices heard. In addition, organizations can use legislative efforts to strengthen the healthcare system, protect and empower nurses, and ensure high-quality care for patients.

Make it easy for nurses to stay informed. Create a space—hospital intranet, minutes of shared governance meetings—that gives nurses quick access to bills affecting regional practice. In New Jersey, the state nursing workforce center website offers this information.

Don’t wait for a crisis to get involved. Get involved now. It doesn’t matter how or where; any platform can serve as a starting point. Start small but start today.

Kathryn Fleming is president of Clinical Consulting Services in North Hanover, New Jersey. Susan H. Weaver is a nurse scientist at Hackensack Meridian Health Ann May Center for Nursing in Neptune, New Jersey. Margaret Hopkins is a staff nurse at Hackensack University Medical Center in Hackensack, New Jersey. Jocelyn Townes is manager of clinical programs–nurse residency at Hackensack Meridian Health. Lisa Guinta is the Magnet® designation director at Hackensack Meridian Health. Tanya Chervoni-Knapp is lead advanced practice nurse for the Center of Advanced Nursing Practice at Hackensack University Medical Center. Christine Conner is the director of professional development and the Magnet Program at Hackensack Meridian Ocean University Medical Center in Brick, New Jersey.

American Nurse Journal. 2025; 20(6). Doi: 10.51256/ANJ062524

References

American Association of Colleges of Nursing. Nursing workforce fact sheet. April 2024. aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet

American Nurses Association. ANA Hill Day 2024: Nurses head to Capitol Hill in record numbers. June 27, 2024. nursingworld.org/news/news-releases/2024/ana-hill-day-2024-nurses-head-to-capitol-hill-in-record-numbers

Congressional Research Service. CRS products from the Library of Congress. crsreports.congress.gov

Healing Politics. Consider yourself asked. healing-politics.org/consider-yourself-asked-2025

New Jersey Collaborating Center. Policy & legislation. njccn.org/policy-legislation

United States Congress. Biographical directory of the United States Congress. bioguide.congress.gov

Key words: advocacy, politics, legislation, nurses’ voices